- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,675.70 / $24,211.20 / $31,611.10
| Facility | | $11,675.70 | $24,211.20 | $31,611.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,109.79 / $59,205.70
| Facility | | $5,840.42 | $22,109.79 | $59,205.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,680.14 / $22,620.40 / $34,179.69
| Facility | | $13,680.14 | $22,620.40 | $34,179.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,123.30 / $32,123.30 / $32,123.30
| Facility | | $32,123.30 | $32,123.30 | $32,123.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,710.40 / $22,788.02 / $35,190.05
| Facility | | $19,710.40 | $22,788.02 | $35,190.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,109.79 / $59,205.70
| Facility | | $5,840.42 | $22,109.79 | $59,205.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,109.79 / $46,269.78
| Facility | | $5,840.42 | $22,109.79 | $46,269.78 |